HomeMy WebLinkAbout0894 i
~eCl~~ation ot DofnlCile and Citizenship ~ ~ g$ 2~
TO THE STATE AND COUNTY TAX ASSESSOR, •
Sl. lUC1E COUNTY, FIORIDA:
Thes is my declaration of Domicile and Citizenship in the State of Florida that I am filing this day in actordance and
~n conformity with Chapter 222, Section 222.17, Florida Statu':•s.
I was fo~merly a legal resident of ~~6' ~ J
(City) (State)
and I resided at ~3 S v ~~~~f~!~_ __'~z`'">___. Howeve~ 1 have changed my domiGle
(Street and Number)
ro and am and have been a bona fide resident of the State of Florida since _ _ day of i
~~/~~rZ'<~f 19_(o y 7~ . t=f~~.~%~~ /YuJ /
- - , and I reside at - - - -
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizenship, adual legal residence and domicile in the State of Florida.
(Insert here any pertinent facts, such as sale of properry or business, or relinquishment of employment
at forme~ domicile, removal of family to new domicile, purchase of home, etc.)
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FIlEO ANO RECQROEO
ST. UiC~E COUN1Y flA. #
ROCEa POITRA~ ~
fCORO VEa F
EO C~RT
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~ I FURTHER CH2TIFY that 1 will comply with all other requirements of a lega) resident of this State.
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~ I FURTHER CERTIFY that I have no intention to return to my former domic,ile, and I intend to remain in FORT
~ PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently.
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~ '~/~/~i~~f~ ~~//~/,f~~
~ (Name) Frank Bon f i e 1 d
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~ ~ 7~. / .I ~'~f~!"if %~L /~GL% ~ - - -
(Address)
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Sworn to~and subscribed before me this day of , 192L.
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••~~.V~1~• ~ ~ Notary Public
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~ By _ ' D.C. My ~ommission expiros
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~ (Ti G~;'4~Wf~d~j~`4l~fliut~ and oripin~l ~il~d with Cl~rk Grcuit Court, and dupliut~ with T~x Ass~ssor.)
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ay 800~
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